Wednesday, February 20, 2013

access all areas

‘I didn’t call you,’ she says, then turns and walks
back into her room, closing the door behind her.

I knock. She doesn’t say anything. When I give it a
gentle push, it opens. I peer round the edge.

‘Can I just come in and have a chat?’

‘Suit yourself. But it won’t do no good.’

The foot of the single bed allows just enough room for
the door to open; the head of it is pushed into a shabby little alcove with a
couple of empty shelves above. The room is a dingy, high-ceilinged affair, painted
so many times and so hurriedly you’d have to break the windows to let in some
air. The fireplace in the centre of the main wall has been boarded up, but the old
mantelpiece is still there. Jean has propped up half a dozen family photos along
its length – two kids in school uniform,
the same kids a little older hugging each other in Christmas hats, a blurry
party photo.

‘My angels,’ she says, rolling a cigarette, scattering
tobacco over the carpet as her hands shake. ‘I’d do anything for those kids.’

‘Jean – do you know why I’m here?’

‘No. Why?’

‘There was a call to say you might have taken an
overdose tonight. Is that right?’

She shrugs, licks along the fag paper, puts the fag in
her mouth and then pats around for a light.

‘What have you taken, Jean?’

‘Look – I’ve been having trouble sleeping. I only moved
in yesterday and it’s noisy, okay? So I took a few extra Tramadol. All right? Is
that such a crime? I didn’t ask you to come here. I only phoned the doctor ‘cos
I wanted to talk to them about stuff. What’s happening with me n’all that.
Because I can’t go on like this, that’s for damned sure.’

She cups a lighter in her hands and leans over it; the
flame illuminates a wizened face so drawn into itself it’s hard to say if she’s
forty or a hundred and two.

‘The thing is, Jean, Tramadol is quite a risky tablet
to overdose on. So I’m duty bound to say you should come up to the hospital to
get checked out.’

‘What? And sit up there for hours? No way. All I wanted
was help with my drinking. That’s it. The hospital won’t be able to do that,
will they?’

‘Right. So what’s the point of going up the hospital?
No one cares up there. They just take one look at you and think piss head. They couldn’t give a toss.’

‘I think they do care, Jean. I mean – I won’t pretend
they’re not busy. And often when it gets busy and pressured, they don’t have
the time to sit down and talk things out in the way they’d like.’

‘They don’t care.’

‘When was the last time you were up at the hospital?’

‘Last year.’

‘What was that for?’

‘I had a perforated duodenal ulcer. It was bad. I was
rushed in for emergency surgery, spent a week on intensive care, six weeks on
the ward and then a couple of weeks in that rehabilitation place. The surgeon
saved my life. He was amazing. Another couple of hours and I’d have been dead.’

‘So you see – they do
care. The surgeon. All those other doctors and nurses. They took care of
you then, didn’t they?’

She takes a crackling drag on her cigarette, and then carefully
picks a piece of tobacco from the tip of her tongue with the dirty thumb and
finger of her other hand. She drops it over the side of the bed and says: ‘Nah
mate. Ain’t no-one cares about me.’

‘Come on, Jean. Let’s go down the hospital.’

She shakes her head.

‘What are your daughters called?’

‘Lucy and Janine.’

‘What do you think Lucy and Janine would say if they
were standing in this room now? They’d want you to come and get help, wouldn’t
they?’

She glances over at the photos on the mantelpiece.

‘They’re my angels, they are. My babies.’

‘So what do you think Lucy and Janine would say if they
were here now?’

‘Mate – don’t bother. I’m not going to no hospital.’

‘I can’t force you...’

‘I know you can’t force me.’

‘But if you stay it’s against advice. Look. I need to
finish off the paperwork before I go. You don’t have to decide right now. Let’s
get a few details down and then talk about it some more.’

‘You can talk about it till you’re blue in the face, I’m
not going.’

‘Are these your tablets here?’

I pick up a carrier bag from the rickety little table
over by the window. Underneath a greying bra are boxes of medication – anti-depressants,
pain relief, sleeping tablets.

‘There’s quite a lot here.’

‘Tell me about it.’

Jean sits cross-legged on the bed, watching me. An aura
of tragedy hangs around her head as palpable as the smoke.

‘I had a good job,’ she says. ‘I bet you’re thinking What? Her? But I did. A really good job.
D’you wanna see my work pass?’

‘Okay.’

She puts the fag back in her mouth, hauls herself to
her feet, then moves unsteadily over to a decrepit chest of drawers. From the heap
of junk on the top of it she untangles a security pass on a lanyard. She tosses
it over to me, then leans back against the chest of drawers and folds her arms.

It’s a rushed portrait, functional, slightly
blurred, but it’s Jean all right – in a uniform, smiling confidently.

‘That’s me,’ she says. ‘Access all areas. That was a really good job, that was.’

I can’t think of anything particular to say about it,
other than to agree it looked pretty responsible. I hand it back.

She weighs it in her hand a moment or two, then shrugs
and drops it back amongst the trash. ‘Now can you just go, please? I’m tired
and I wanna go to bed.’

‘Are you sure you won’t change your mind?’

‘Change my mind?’ she
says, opening the door and then going back to sit on the bed. ‘I think it’s a
little bit late for that, love. Don’t you?’

7 comments:

It's funny, but quite often people'll say I couldn't do your job, and most of the time what I think they mean is I couldn't cope with all the blood & trauma. But actually I think the hardest thing to cope with is a constant exposure to these social deprivation cases. I think overtime they're the things that wear you down the most.

It helps to write about them, I suppose, because it forces you to be objective about it. But still...

Nope - she stayed at home. This piece is a very truncated version of what happened, btw. But after trying every conceivable tactic she still refused. She'd taken 10 tramadol (so she says - I couldn't see any packet evidence), and at that time she was perfectly lucid and oriented, so in the end it was simply a case of reporting the incident to the Out of Hours GP, who'd then pass it on to her own GP. Because she was in her registered place of address, there was nothing the police could've done. I suppose at the end of the day if you think someone has 'capacity' - which she appeared to have - they're perfectly at liberty to do these things, distressing though they are. You can only really start to use a degree of force if the harm they've done to themselves makes them less able to prove capacity (or resist).

I suppose in the end you're supposed to accept these things, but like I said to tpals, I think it does have a cumulative effect. We seem to go so many where I work!

Hey Jacks

I was only ever in the Cubs, and I only did that because they played football and cooked sausages. But yes - Be Prepared - which is why I always carry chewing gum.

Truth is, for this particular job there were two of us, but if you're working on the car you often do get called out to psych situations on your own. Control will try to judge on the phone if it's safe or not, but seeing as we work in a small city, chances are you're on scene before you get any updates to the contrary. They do say that 'the clock stops' once you're outside / standing off, so if you have safety concerns you can wait for back-up. It's a difficult judgement to make though, esp. if you think someone's in trouble. The responder just has to decide in each case whether they feel safe going in on their own.

Here in the UK if you think the patient has capacity, you can't force them to travel. Again, a difficult judgement call, and one that's influenced by how serious an OD you think it is, or how likely they are to take more once you've gone. I've been to other jobs where we haven't left, have called the police, and one way or another have stuck it out till we've managed to get them to travel. But the bottom line is, if someone has capacity, it takes a long legal process to forcibly take them out of their home.